BEUDAMED
    FDA Adverse Event Malfunction Summary report: N

    POWERED WHEELCHAIR

    MDR report key: 3935741 · Received July 15, 2014

    Report

    Report Number
    1525712-2014-03701
    Event Type
    Malfunction
    Date Received
    July 15, 2014
    Report Date
    June 9, 2014
    Manufacturer
    UNKNOWN
    Product Code
    ITI
    Product Problem
    Yes
    Report Source
    Manufacturer report
    Reporter Location
    AL, US
    Reporter Occupation
    MEDICAL EQUIPMENT COMPANY TECHNICIAN/REPRESENTATIVE

    Narratives

    Description of Event or Problem · 1

    PER END USER MOTOR WAS CHATTERING FOR A FEW DAYS AND THEN QUIT WORKING. CHAIR ON LOAN FROM A FRIEND.

    Devices

    Seq Brand Generic Product Code Manufacturer Model Lot UDI-DI
    412377 POWERED WHEELCHAIR 890.3860 ITI UNKNOWN P7E

    Patients

    Seq Age Sex Outcome Treatment
    1 Other